I have taken you through physiological, pathological and the exercise therapy side of the bone story that has been running on this blog. Today I will tell you what are the methods you should use or atleast be aware of to detect and identify any osteoporotic signs in your bones.
Now osteoporosis can cause secondary problems and it also can be caused by other diseases or disorders already existing in your body that are asymptomatic or silent. So what you should look out for are obvious signs, signs that can't otherwise be communicated by your body if it were normal. Osteoporosis is primarily detected by dual energy x ray absorptiometry (DXA) or by single energy x ray absorptiometry (SXA), although DXA is more accurate. DXA tests show T - score and Z - score, you have to keep in mind the T- score as it is the determining factor in Bone Mineral Density. The normal bone mineral density T - score is - 2.5 a standard deviation of more than or equal to 2.5 from the normal is considered to be red signal for osteoporosis. DXA test is like the final frontier of sorts in the detection process as it clearly showcases the structure of the bone and its density. Before we arrive at DXA there are certain serological tests that need to be run to zero down on bone mineral density (BMD)test. The blood test that is essential is serum calcium, serum alkaline phosphatase (Alk Phos), serum parathyroid hormone (PTH), Vitamin D, thyroid profile and for women above the age of 45 years Follicle Stimulating Hormone (FSH), Leutinising Hormone (LH) to check for onset of menopausal symptoms. The relevance of these tests are as follows :
1. Serum calcium - As I have explained in my previous posts that the reason for loss of bone density is the loss of bone calcium into the blood. Therefore serum calcium levels can be a good indicator for BMD. Normal levels of serum calcium are 8.5 - 10.5 mg/ dL. Elevated serum calcium show hyperparathyroidism or malignancy and decreased levels of calcium show malnutrition and osteomalacia. Hyperparathyroidism as we know is due to the reactivity of the lack of calcium in the blood and imbalance in the remodelling and modelling of the bone. However if the levels show decline in calcium it means that there isn't enough calcium in the body to be mineralised in the bone and hence high PTH would again try to remove calcium from bones to level blood calcium. Malnutrition is the major reason for a drop in blood calcium levels. Malnutrition could be lack of dietary calcium or Vitamin D or due to asymptomatic intestinal disease like celiac sprue, chronic intestinal irritability,intestinal cancer etc.
2. Serum Vit D - Vit D as we all know by now is a factor important in the absorption of calcium in the gut but also for its mineralization in the bones. Serum Vit D of > 32 ng / ml is considered normal. Vit D levels need to be adjusted by supplementation through oral vials or injection.
3. Serum PTH - Parathyroid hormone is the most crucial factor to determine the onset of osteoporotic activity in the bones. The serum elevated levels of PTH signify the loss of bone mineral density and aggrevation of remodelling sites in the bones cells, also the elevation of calcium in the blood and alkaline phosphatase. Normal levels of serum ALP is 20 - 140 IU/ L. Bone alkaline phosphatase levels elevate as it is a byproduct of the bone activity. Imbalance in the ratio of remodelling to modelling sites can lead to elevation of ALP levels. PTH levels when found declined can mean malignancy (cancerous) of the bone. Further biopsy will be required to indentify malignancy. PTH levels can also be elevated if TSH levels are imbalanced therefore a proper TSH, T3, T4 levels of the thyroid activity should be checked.
4. FSH and LH - In women who are in their perimenopausal stage around the age of 45 - 50 years and in given recent scenario even lesser age group have lower estrogen levels in their blood which only means their stimulating hormones will have elevated levels in the blood. Lower estrogen only means that there is certainly going to be imbalance in the bone mineral ratio, PTH will be elevated as estrogen brings about more bone reodelling sites and could also navigate into the inner (trabeculae) bone cells to weaken the structure.
Now you know your tests and you know what the test results translate into, but be sure to know that detecting osteoporosis can also mean detecting an underlying disorder which has been laying there silent all this while. Most of the times treating the primary cause of osteoporosis takes care of the bone disorder itself. Be sure of any such disorder priotise to treat it first and follow the therapy I have earlier explained for osteoporosis.
I will soon be writing on the diet therapy for osteoporosis and busting many myths too. So keep reading and see you here soon.
Wish you wellness,
Neha Wasnik
R.D
Related articles - http://wellnessandi.blogspot.com/2009/08/osteoporosis-metabolic-cause-and.html
http://wellnessandi.blogspot.com/2009/09/exercise-for-osteoporosis.html
Showing posts with label Hormonal Disorder. Show all posts
Showing posts with label Hormonal Disorder. Show all posts
Saturday, October 10, 2009
Tuesday, August 18, 2009
OSTEOPOROSIS - From where does this silent killer creep in?
First of all I apologise for this long over due sabatical from the blog. I was working on bringing you something very close to my heart and I have now compiled a series of article topics which will be including my friend's request to write on menstrual body pain and also about fitness for sit at home people who just don't want to go to the gym.
So about this series of blog articles I am going to write everyday will be on Women's Health (of all ages). Before al my male readers turn away let me tell you some of the things I unravel to you is applicable to today's man too. If you are close to any female kind and I hardly doubt if you're not then this series is for you.
Osteoporosis has long been considered as a bone disorder of the elderly. Frankly not everyone knows what it factually is. All they can tell you is something to do with the bone and perhaps as far as a fracture in women. Well people guess what times have changed and we are solely responsible for it. In 2005 my mother was experiencing excruciating pain in one of her hip joint, she just neglected for a while thinking it was fatigue. It got to a point where she couldn't sit down or bend to pick things up from the floor. Needless to say she almost faced immobility, as I clearly recall that day when I came home from my health club to find my Mom struggling to get up from the bed. She then (somehow) got an MRI, Bone Density test, Serum calcium, Vit D, hormonal tests done. We found she wasn't osteoporotic, yet. She was osteopenic, which only meant that it will be sometime soon when she would be categorically under OSTEOPOROTIC status. That day when she found out she knew what I meant when I told her deliberatly deafened ears to start working out and stop comfort food as an excuse to feeling exhausted. In one year's time she not only lost 30 Lbs of dead weight but reversed her bone deterioration, of course with diet and apt exercise module along with Vit D supplementation. You have to really coax her today to give up one day of workout. So the question still remains what is it that we do to end up being susceptible to osteoporosis and that apart why do medical sciences tag it a 'SILENT KILLER'? I can understand your dilemma coupled with curiosity, but osteoporosis does more harm to our body than just bone frailty. This is what I will write about in this series.
To understand the pathophysiology (its effects) of osteoporosis we need to understand what is our bone structure made of. Simply it is nothing but a meshwork of protein molecules which have mineral fixations into it making it look like a wholesome sturdy structure. Protein forms the major support for the actual bone, while minerals like calcium, phosphorous, give it its sturdy tough body. Without the adequate mineral deposition in the protein meshwork the bone is just a croche of protein with big holes in it. Remember how you grow taller upto certain age and then just stop growing no matter how tall you want to be? Thats called growth of the epiphysis simply explained when we're young as in really small babies our bones aren't completely formed to what they are now. There are spaces between the firm bone structure that awaits development so we grow taller into adulthood. This process takes place along with the growth hormone by constant mineral deposition in the protein structure of the bone. At some point the growth hormone release is inhibited and the bone growth eventually stops. Our bones go through a process called as absorption and this continues upto the age of 35. After 35 however bones go through a turnover process i.e. absorption and resorption. The bone turnover determines the actual net bone density, which only translates into whether your bone is absorbing more calcium or giving away more calcium. This turnover is initiated by the overall process called ageing. Secondary to natural stimulus for bone resorption are factors that accelerate bone calcium resorption like obesity (too much weight on the ones), calcium defeciency(not enough calcium in the blood), Vit D defeciency, thyroid hormone abnormality, malnutrition overall, oestrogen imbalance. if you manage to do all the above mentioned activities you'll be succesfull in depleting your bones from calcium thus inviting with warm arms a permanent guest called OSTEOPOROSIS to your humble body. What osteoporosis will do after it starts developing is frailty in your physical self. Frailty leads to accidents, or immobilisation like in the case of my mom. Frailty of the bones also means your nervous plexi which were protected by adequate bone space is now facing muscular pressure as the body structure is weak and cannot hold major muscles in their original way. If the nerves are pressed there is neural damage symptomatic as dysfuntional part of the body the nerves are supplying brain impulses to. Now you can multiply all this into why this silent unwanted guest is a killer, a silent killer. Watch out for more on this topic as I unravel more about Osteoporosis and general health.
So about this series of blog articles I am going to write everyday will be on Women's Health (of all ages). Before al my male readers turn away let me tell you some of the things I unravel to you is applicable to today's man too. If you are close to any female kind and I hardly doubt if you're not then this series is for you.
Osteoporosis has long been considered as a bone disorder of the elderly. Frankly not everyone knows what it factually is. All they can tell you is something to do with the bone and perhaps as far as a fracture in women. Well people guess what times have changed and we are solely responsible for it. In 2005 my mother was experiencing excruciating pain in one of her hip joint, she just neglected for a while thinking it was fatigue. It got to a point where she couldn't sit down or bend to pick things up from the floor. Needless to say she almost faced immobility, as I clearly recall that day when I came home from my health club to find my Mom struggling to get up from the bed. She then (somehow) got an MRI, Bone Density test, Serum calcium, Vit D, hormonal tests done. We found she wasn't osteoporotic, yet. She was osteopenic, which only meant that it will be sometime soon when she would be categorically under OSTEOPOROTIC status. That day when she found out she knew what I meant when I told her deliberatly deafened ears to start working out and stop comfort food as an excuse to feeling exhausted. In one year's time she not only lost 30 Lbs of dead weight but reversed her bone deterioration, of course with diet and apt exercise module along with Vit D supplementation. You have to really coax her today to give up one day of workout. So the question still remains what is it that we do to end up being susceptible to osteoporosis and that apart why do medical sciences tag it a 'SILENT KILLER'? I can understand your dilemma coupled with curiosity, but osteoporosis does more harm to our body than just bone frailty. This is what I will write about in this series.
To understand the pathophysiology (its effects) of osteoporosis we need to understand what is our bone structure made of. Simply it is nothing but a meshwork of protein molecules which have mineral fixations into it making it look like a wholesome sturdy structure. Protein forms the major support for the actual bone, while minerals like calcium, phosphorous, give it its sturdy tough body. Without the adequate mineral deposition in the protein meshwork the bone is just a croche of protein with big holes in it. Remember how you grow taller upto certain age and then just stop growing no matter how tall you want to be? Thats called growth of the epiphysis simply explained when we're young as in really small babies our bones aren't completely formed to what they are now. There are spaces between the firm bone structure that awaits development so we grow taller into adulthood. This process takes place along with the growth hormone by constant mineral deposition in the protein structure of the bone. At some point the growth hormone release is inhibited and the bone growth eventually stops. Our bones go through a process called as absorption and this continues upto the age of 35. After 35 however bones go through a turnover process i.e. absorption and resorption. The bone turnover determines the actual net bone density, which only translates into whether your bone is absorbing more calcium or giving away more calcium. This turnover is initiated by the overall process called ageing. Secondary to natural stimulus for bone resorption are factors that accelerate bone calcium resorption like obesity (too much weight on the ones), calcium defeciency(not enough calcium in the blood), Vit D defeciency, thyroid hormone abnormality, malnutrition overall, oestrogen imbalance. if you manage to do all the above mentioned activities you'll be succesfull in depleting your bones from calcium thus inviting with warm arms a permanent guest called OSTEOPOROSIS to your humble body. What osteoporosis will do after it starts developing is frailty in your physical self. Frailty leads to accidents, or immobilisation like in the case of my mom. Frailty of the bones also means your nervous plexi which were protected by adequate bone space is now facing muscular pressure as the body structure is weak and cannot hold major muscles in their original way. If the nerves are pressed there is neural damage symptomatic as dysfuntional part of the body the nerves are supplying brain impulses to. Now you can multiply all this into why this silent unwanted guest is a killer, a silent killer. Watch out for more on this topic as I unravel more about Osteoporosis and general health.
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